Ideal Dose and Injection Site for Gummy Smile Treatment with Botulinum Toxin-A: A Systematic Review and Introduction of a Case Study.

The objective of this article is to review ideal injection point and ideal dose of botulinum toxin-A injections to treat different types of gummy smile, and to present a case treated with the recommended method. An electronic search of literature was carried out by using PubMed, Embase, and Google Scholar. Reference lists of studies were also hand-searched for relevance. According to inclusion and exclusion criteria, five prospective studies with 135 subjects were included in this systematic review. Injection of botulinum toxin-A is a noninvasive and temporary treatment option for gummy smile, and the Yonsei point is a safe and reproducible injection point for treatment by practitioners of all types of gummy smile.

Effects of clinical local factors on thickness and morphology of Schneiderian membrane: A retrospective clinical study.

BACKGROUND: It was informed that the thickness of maxillary sinus membrane may be affected by the local and patient-related factors in the literature. PURPOSE: The aim of this retrospective study is to evaluate factors that may have an influence of the thickness and morphology of the maxillary sinus membrane. MATERIALS AND METHODS: A total of 414 cone beam computed tomography images of 207 patients were evaluated. Radiographic parameters were evaluated at each maxillary premolar and molar tooth regions. Statistical analysis was performed to assess the association between the maxillary sinus mucosa thickness and morphology. The following factors including gender, periodontal bone loss (PBL), bone density, amount of residual alveolar bone at the edentulous space, vitality of the teeth present, and anatomical relationship between the sinus floor and posterior teeth were evaluated. RESULTS: The mean thickness of maxillary sinus membrane ranged between 1.47 to 2.92 mm and was significantly thicker in male subjects (P < .05). Positive correlation was detected between the sinus membrane thickness values in each posterior tooth region (P < .05). Thickening of the membrane was noted in 53% of the scans. The most commonly observed morphological change was flat thickening of the membrane (21%). No correlation was found between the evaluated local factors on the thickness and morphology of the maxillary sinus membrane (P > .05). CONCLUSIONS: Tooth vitality, residual alveolar bone height, and PBL seem to have no effect on the thickness and morphology of the maxillary sinus membrane.

The radiological evaluation of posterior superior alveolar artery topography by using computed tomography.

BACKGROUND: Posterior superior alveolar artery (PSAA) is the most important limiting anatomic structure while lateral approach sinus surgeries. PSAA should be taken into consideration to avoid bleeding during preparation of bony window. PURPOSE: The aim of this article was to inform topography of PSAA and to evaluate measurements of this vital structure. MATERIALS AND METHODS: Three hundred and fifty-four cone-beam computed tomography (CBCT) images of PSAA from 177 patients were evaluated retrospectively. Localization of PSAA, diameter of PSAA, classification of PSAA diameter, distance between PSAA and crest, buccal bone thickness, palatal bone thickness, crest height, and crest width were recorded for each posterior tooth separately. RESULTS: The mean age of 177 patients was 54.05 ± 18.33 years. Although the most frequent localization of PSAA was intraosseous in premolar region, they were below Schneiderian membrane in molars. PSAA diameter was measured frequently less than 1 mm for all posterior teeth. Although palatal bone thickness was higher in premolar region than molars, no statistical relationship was found between tooth region and buccal bone thickness (P > 0.05). The width of residual ridge was measured both wider apically and posteriorly. Positive correlation was observed between buccal bone thickness and PSAA diameter in first molar and premolar regions (P < 0.05). CONCLUSIONS: Detailed evaluation of patients by CBCT provided us the opportunity to draw topography of PSAA and inform about overall measurements of PSAA in all posterior teeth region.